地佐辛镇痛对妇科腹腔镜术后认知功能的影响

目的 探讨应用简易精神状态量表(mini-mental state examination,MMSE)测试方法,评定妇科腹腔镜术后全麻复苏期躁动患者应用地佐辛镇痛治疗对其术后认知功能的影响.方法 观察昆明市妇幼保健院2015年1月至2015年12月间择期妇科腹腔镜全麻手术患者210例,ASA分级Ⅰ或Ⅱ级,于拔除气管导管后转入PACU(ICU),根据患者入室时躁动情况评分,将其分为A、B、C 3组,每组各70例,A组,严重躁动者及时给予地佐辛10 mg;B组,躁动轻微者延迟5~10 min,给予地佐辛10 mg;C组,不给地佐辛.3组患者应用MMSE测试方法评定其评分,记录入室即刻及应用地佐辛后15 min,30 min,60 min及术后24 h的MMSE评分情况.结果统计结果显示患者从入室至使用地佐辛后30 min以内MMSE评分P<0.05,差异有统计学意义;60 min评分显示出室时及术后24 h各指标评分P>0.05,3组比较差异无统计学意义.结论 妇科腹腔镜术后全麻复苏期躁动患者应用地佐辛镇痛治疗对其术后认知功能无显著影响,地佐辛可安全应用于妇科腹腔镜术后全麻复苏期躁动患者镇痛、镇静治疗.

The Effect of Dezocine Analgesia on Cognitive Function of Patients after Gynecological Laparoscopic Surgery

Objective To discuss the application of Mini Mental State Scale(the mini-mental state examination MMSE) test in assess the effect of dezocine analgesia therapy on the cognitive function of patients with agitation in recovery period of general anesthesia after gynecological laparoscopic surgery.Methods We observed210 cases of elective gynecologic laparoscopic surgery in our hospital from January 2015 to December 2015,ASA grade I or II.All patients were transrered to PACU(ICU) after extubation, and were divided into three groups:A,B,C group,each with 70 cases in each group.Patients with severe agitation in A group were timely given 10 mg of dezocine, patients with mild agitation in B group were given 10 mg of dezocine after a delay of 5~10 minutes,and patients without agitation in C group were not given dezocine.Then the MMSE test was performed to evaluate the cognition scores of patients in the three groups.The MMSE scores immediately, 15 minutes, 30 minutes, 60 minutes after given dezocine and 24 hours after operation were recorded.Results The statistical results showed that there were significant differences in the MMSE scores of patients immediately and at 30 minutes after given dezocine between three groups(P<0.05);and there was no significant difference in the MMSE scores of patients at60 minutes after given dezocine and 24 hours after operation between three groups(P >0.05).Conclusion Dezocine analgesia therapy has no effect on the cognitive function of patients with agitation in recovery period of general anesthesia after gynecological laparoscopic surgery.Dezocine can be safely used for analgesia and sedationtreatment for patients with agitation in recovery period of general anesthesia after gynecological laparoscopic surgery analgesia,sedation agitation.